No Fear Shakespeare: Measure for Measure: Act 2, …

As outlined in the VBP Roadmap, the State has established a common set of quality measures for each VBP arrangement based on national standards and the recommendations from the Clinical Advisory Groups, Technical Design Subcommittees, and approved by the VBP Workgroup.

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Syphilis is known to have a wide variety of clinical manifestations, including the following:

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Some laboratories use a reverse-sequence screening algorithm with automated treponemal EIA or CIA as the initial screening test, followed by confirmation with the nontreponemal RPR (Figure 4: Alternative, Reverse Algorithm for Syphilis Screening and Diagnosis). When discordant results are provided by laboratories using the alternative algorithm (i.e., reactive EIA/CIA with a nonreactive RPR), the Centers for Disease Control and Prevention recommend that a second different treponemal test (ideally based on different antigens than the first test) be performed to confirm the results of the first nonspecific antibody result. Clinicians should request information regarding the screening algorithm of their laboratory and be familiar with the testing sequence used. Table 2: Interpretation of Results of Reverse-Sequence Testing for Syphilis, below, provides recommendations for interpreting results when the reverse algorithm is used.

Each measure is classified as either Pay–for–Performance ..

Syphilis serologies are complex and require two-stage testing as described in Figures 3 and 4, below. Note the following features of syphilis serologies relevant to diagnosis:

Ferry AP and Font RL: Carcinoma metastaticto eye and orbit. I A clinicopathologic study of 227 cases. ArchOphthalmol. 92:276–286. 1974.

Nonconsensual Medical Experiments on Human Beings

Update 6/15/17: The links below include updates to the TCGP/IPC, HARP and HIV/AIDS Quality Measure Sets. This update reflects a modification to five measures addressing the initiation and utilization of medication-assisted treatment for alcohol and opioid dependence as well as the Continuity of Care Measure. The updated measure titles are redlined in the documents below.

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The "serofast" state refers to a situation where RPR or VDRL decline but fail to completely revert to nonreactive. About 15-41% of treated patients remain serofast (Clement et al, 2014).

Shields CL, Shields JA, Gross NE, et al:Survey of 520 eyes with uveal metastases. Ophthalmology.104:1265–1276. 1997.

Syphilis Guideline - AIDS Institute Clinical Guidelines

The following Quality Measure Sets provide the listing of measures for the 2018 VBP contracting year including all Category 1 and Category 2 measures.

New York ranks fifth among the 50 states in rates of primary and secondary syphilis, with 2,455 cases reported in 2016 [3].

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The deliberate failure to treat a group of male Negroes in Macon County(near Tuskegee), Alabama who had syphilis begun in 1932 and ended, by unfavorablepublicity, in 1972. This experiment is difficult to discuss, because somuch was wrong with it. In my opinion, there are three major mistakes. Pagecitations are to by James H. Jones, a historian and scholarin bioethics.

Jun 21, 2010 · Syphilis of the central nervous system instances

Guatemala syphilis experiments worse than Tuskegee.

According to Goldman (2003), all patients require clinical and blood testing followup 6 and 12 months after treatment. Patients with HIV should also be evaluated at 3, 9 and 24 months after treatment. Treatment failure is defined as failure of RPR/VDRL to decline by at least 2 dilutions within 6 months of treatment, or a sustained 4-fold increase in RPR/VDRL at some point after treatment. If treatment failure is not noted, all patients with otosyphilis should undergo repeat CSF examinations at 3 and 6 months following therapy and then every 6 months until CSF is normal.